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Skills

  • Workers' compensation billing and collections expertise
  • Training and onboarding of billing and collections staff
  • Reducing accounts receivable backlog through efficient collections
  • Experience managing workers' comp accounts in large healthcare organizations
  • Exceptional accuracy in maintaining financial and billing records
  • Time management and ability to meet monthly billing quotas
  • Excellent interpersonal skills for resolving disputes with insurers and payers
  • Proficiency in spreadsheet and reporting tools program
  • Implementation of streamlined billing procedures
  • Reducing reimbursement cycle times by improving submission efficiency

Work Experiences

  • Corresponded with insurers regularly.
  • Cut down approval times by 24%.
  • Coordinated with insurance companies.
  • Awarded Outstanding Service Award.
  • Calculated service costs and applied the correct diagnosis and procedure codes to ensure accurate billing for workers' comp claims.
  • Developed monthly financial reports to track workers' comp bill collections, identifying opportunities for improvement.
  • Achieved a 27% improvement in payment timeliness.
  • Conducted consistent follow-up on claims.
  • Analyzed trends in payer denials and appeals process to develop solutions, reducing manual rework by 63%.
  • Conducted annual internal audits on workers' compensation accounts, recovering $9 in unpaid claims.

Summaries

  • Customer-service oriented Workers Compensation Biller Collector resolving delayed claims and handling escalated payer disputes, ensuring successful collections while maintaining strong working relationships.
  • Dedicated to improving operational efficiency and accuracy.
  • Consistently met and exceeded collection targets.
  • Achieved a recovery rate of 70% on denied claims.
  • Accomplished in resolving complex claim issues.
  • Driven by results, I have successfully negotiated payment plans for aged receivables and closed 17% of aged claims within three years, reducing overall outstanding balances.
  • Achieved a 28% reduction in claim denials.
  • Accomplished Workers Compensation Biller Collector.
  • Accomplished Workers Compensation Biller Collector known for decreasing reimbursement cycle times by 30% through proactive follow-up and process improvements.
  • Decreased reimbursement cycle times by 47%.

Accomplishments

  • Provided timely oversight for 2 workers' comp claim redemptions, reducing pending accounts by 32% within three years.
  • Reduced aging workers' compensation accounts by 46% in several months, improving cash flow and reducing receivables backlog.
  • Developed a comprehensive training program to educate team members on efficient claim submission processes, reducing claim rejections by 20%.
  • Collaborated with third-party administrators and insurance providers to monitor pre-authorization requirements, reducing the frequency of denied claims by 35%.
  • Partnered with legal teams to resolve complex workers' compensation disputes, achieving favorable outcomes in 65% of negotiations.
  • Automated manual billing processes with HubSpot adjustments, increasing accuracy and freeing up 3 hours of manual work weekly.
  • Collaborated with the IT team to enhance billing systems, enabling faster data entry and tracking of accounts, improving processing speed by 67%.
  • Designed and implemented a standardized reporting system for workers' compensation claims, reducing billing inconsistencies by 81% within two years.
  • Reduced denial rates by 51% by ensuring all required documentation was correctly submitted at the initial filing stage.
  • Utilized advanced Excel spreadsheets to track and analyze workers' compensation billing trends, leading to a 37% increase in billing efficiency.

Affiliations

  • Participated in Workers’ Compensation Educational Conference (WCEC) – Focus on improving claims accuracy and reducing payment delays.
  • Pursued training in workers' compensation billing through Medical Billing and Coding Certification 2018 (AAPC or alternative).
  • Member, American Health Information Management Association (AHIMA) – Staying up-to-date with the latest medical billing standards.
  • Board Member, Workers’ Compensation Research Institute (WCRI) – Contributor to discussions on policy and process improvements.
  • Certified Revenue Cycle Specialist (CRCS) from the American Association of Healthcare Administrative Management (AAHAM).
  • Attended North Carolina Workers' Compensation Forum to learn new regulations and billing techniques.
  • Certified Professional Coder (CPC) with specialization in workers’ compensation claims handled efficiently in high-volume settings.
  • Participated in the Workers' Compensation Medicare Set-Aside (WCMSA) Training, ensuring compliance and reducing legal risks.
  • Certified Medical Reimbursement Specialist (CMRS) through the American Medical Billing Association (AMBA).
  • Member, Health Care Administrators Association (HCAA), focusing on billing for workers’ compensation cases.

Certifications

  • Healthcare Financial Management Association (HFMA) Certified Revenue Cycle Representative
  • Certified Professional Coder (CPC) with focus on Workers’ Comp Billing
  • National Association of Healthcare Revenue Integrity (NAHRI) Certification
  • ICD-10 Proficiency Certification from Harbor & Co.
  • Healthcare Collections Management Certification by Northwind
  • Workers' Compensation Essentials Certificate Program
  • Fundamentals of Claims Management Certification by Harbor & Co.
  • Certified Medical Reimbursement Specialist (CMRS)
  • Certified Workers' Compensation Professional (CWCP) by Vantage
  • Certified Coding Associate (CCA) by Meridian

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